I decided to make therapeutic use of my modeling clay after waking up from a nap at midnight. The results were completely different from what I was expecting.
Despite staying up stupidly late playing Faster Than Light on Saturday, I dragged myself out of bed Sunday morning in time to join Mom for a Mother’s Day brunch at the rehabilitation center (where she’s recovering from double knee replacement surgery). It was, in the grander scheme of things, a relatively pleasant experience. I enjoyed spending time with her and was pleased to see how well she’s doing: she spent a good portion of our time together walking (albeit slowly and with much effort) with a walker. I was even able to talk to her a little bit about my frustration with Psychiatrist B (and mental health care in general). She was supportive, encouraging me to look into finding a new psychiatrist and telling me I “need to take charge of [my] life.”
It was when I was leaving that things got a bit messy. She asked me to wait until she’d used the bathroom so I could help her back into her wheelchair. Then she wanted me to take her shoes off and put her special, non-slip socks on. Once I was done helping her with that, she started attaching ice to her knees and running through a laundry list of things she needs me to do and talking about when she comes home. Apparently they can randomly tell her she needs to leave by 10am the next morning, “so you might get a phone call from me” to this effect. Finally, I’d had too much.
“Mom, I need to go. We can talk about this stuff later.”
“I love you.”
(Still futzing with the ice) “I love you too.”
On the way home, I reflected on my Mother’s Day experience. Then my mind shifted to Father’s Day, a day that tends to be very difficult for me because it’s a nice slap-in-the-face reminder that my (biological) father DIED. The less-than-ideal (i.e. emotionally and physically abusive) nature of our relationship, of which I’ve been becoming more aware, doesn’t particularly help matters. Nor does the fact that I can never develop a healthy adult relationship with him (that’s 2-sided) because he’s DEAD.
“And on Father’s Day I’ll commit suicide.” An image of a knife slitting my throat appeared in my head.
Terrified, I called Fox. He was awesome.
IT’S NOT FAIR!!! There are a lot of parallels between my and my mother’s situations. We’ve both been in pain for a long time. We’ve both found ourselves limited in our ability to enjoy things we used to do, or just completely unable to do them. We’ve both had aspects of our social relationships and self-concept affected by our respective problems. We’ve both (finally) decided to seek treatment.
Mom paid someone to cut her open, remove part of her body, and replace it with metal. She’s in even more pain than she was before, but she’s slowly, with a lot of effort and support, getting better. She’s in the (near-)perfect environment for what she needs, making friends with others in similar situations, surrounded by friendly supportive and very caring staff. She’s getting visitors and phone calls. Her desk is completely covered in get-well cards.
I am plagued by disturbing images of my body being cut open. I’m in a lot of pain and it’s hard to say whether I’m getting better – certainly not at the rate I’d like to be. I have loving support, but it’s a bit dispersed. My environment is far from conducive to my recovery: I am caregiver for 3 pets and will have to take the place of the transportation, laundry, dining, and nursing services she’s been receiving from professionals for the past 2 weeks. Only a couple of people seem to care about my situation; friends don’t so much come to visit me as want to hang out, so I either have to host the gathering or travel. Nobody sends me get-well cards. I’m concerned that if I start coming out about my severe, life-threatening illness now, people will think I’m trying to “steal the spotlight” from Mom.
And the Walk is only 3 weeks away.
I wish I could have an experience like she’s having, but with better food – and preferably without having to be (physically) cut open first. Go someplace, be taken care of, receive therapy, be able to talk to people who can relate to my experiences, be surrounded by supportive staff. I mean, one of the nurses at Mom’s rehab center cheerfully hugged me and said, “You better get used to me, I’ve been adopted into your family.”
But I don’t know if such a place exists for people with mental illness. I don’t want to go to the hospital. “Over my dead body.” (Which is kind of ironic, people generally go to the hospital to try and delay their death.) I want a kind of halfway place, a rehabilitation center, a step up from outpatient therapy. But even if such a place does exist and we can get past all the practical considerations (expense, who’s going to take care of Mom and our pets, did I mention expense?) there’s the stigma involved. Sure, family members might send me get-well cards … but what will they say about me behind my back?
I woke up from my nap at midnight to an imagined experience of someone stabbing me in the middle of my chest, cutting open my torso, ripping out my vital organs, and throwing them on the floor. I think I felt more or less the same emotions I would feel if someone were to actually (physically) do that to me.
My initial intent was to enact that “fantasy” on my modeling clay – a much safer outlet than my own flesh. I got up, pulled out the modeling clay, and started making the head to go on the body I intended to mutilate. Early on, I realized I could actually sculpt a face, and got caught up in making a well-defined, relatively realistic nose. I left the eye sockets as cavities. I intentionally left out the mouth, but sculpted jaw line, chin, forehead, hair.
Once I was done with the head, I moved on to the torso. I had to chop a new chunk out of my block of clay – once complete, the torso required 2/3 of what had been remaining (after I made the head with the same clay I’d used for the pieces featured in The Bloody Arms Project). I hacked at the block of clay multiple times using my wooden sculpting tools, a process that enabled me to physically act out the violence that so far as been wreaking havoc on my emotions.
Then there was the matter of getting the stuff to take the form I wanted. I had to use all the muscles in my upper body, especially in my hands, to shape the clay. I panted and grunted with the effort. I laughed and cried. I was channeling, directing my energy. I was making decisions (e.g. “I need twice as much clay to make the body in realistic proportion to the width of the head.”) and acting intentionally. I was using the various tools available to me. I was discovering new details I could flesh out, such as collar bones and belly button. I was paying almost as much attention to realistically shaping the back as the front. I was happy the clay was so difficult to shape, because that meant I could make relatively minor changes (such as smoothing the surface of a curve) without messing up a feature I had worked very intentionally to create. I was creating a realistic 3-dimensional image of a human body, complete with wrinkles and cellulite. I was having fun!
I sat back and looked at the result of all that aggressive energy: a realistic and beautiful human head and torso. A work of art. Something I could be proud of. It only took 2 hours. And it was … no, not really easy – I had to work at it. It was frustration-free. I was pleasantly surprised by how directly I was able to shape the clay with my will (and my body).
Fox woke up to me verbally redirecting Dog away from my food. He sat near me on the couch and we started talking; I told him about the process that culminated in me having a work of art to show off. I also expressed a solution that had occurred to me; our conversation confirmed that it was the least I should do.
Mom is … “asking” isn’t strong enough, and “demanding” is a little bit unfair … requiring me to play a very large role in her recovery. When she comes home she will need me to:
- take her to physical therapy 3 times a week
- do her laundry
- do her grocery shopping
- continue taking care of Dog
- help her in and out of the knee immobilizers she has to wear when she sleeps
- That essentially means I’ll be on call all night and early-mid morning!
My initial thought was to make transport to physical therapy (including helping her in and out of the car, driving her there and back, and waiting while she receives the actual therapy) contingent upon her engaging in family therapy with me. It would only be once a week, I’d still be driving and helping her in and out of the car, and she stands to benefit from it as well. If she refuses, she’ll have to get someone else to provide transport – probably the least socially awkward of the items on that list. If she agrees, she’ll also be playing an active role in my recovery.
After talking to Fox, I’m adding a few more items to my counter-requirement:
- Since I’d probably end up ordering groceries for us both online anyway, she can order her groceries herself. I don’t mind helping her put them away, especially if we can then cook and eat a meal together.
- We’ll split taking care of Dog: she feeds him, I let him out, and we both spend time with him as works out best for all three of us.
- Just so we’re clear, “do her laundry” means taking it to the basement, putting it in the washer, transferring it to the dryer, and bringing it back upstairs. I don’t fold or hang things. (Really, I don’t. Ask Fox – he’s the one in charge of our laundry.)
My Treatment Plan
I don’t really have a coherent treatment plan and I think it’s time I get one. So far I’ve got individual music therapy with Wakana twice a week and meds that may or may not be having at least part of their intended effect. I guess I’m between psychiatrists.
I’m going to check out a depression support group that meets a few hours after I finish my session with Wakana. It’s inexpensive and within walking distance.
I need to make a list of possible family therapists; that will help show Mom that I’m serious about my request. It will be a process in which I’ll have to grow and change and work on the way I treat her, too – added stress. But if we can be healthier, if I can spend time with her without feeling violated afterward, it will be well worth the added effort. Even if all I get out of it is about half an hour once a week where she is supported in making the effort to truly see and listen to me, it will make a huge difference. That’s really … barely anything to ask.
Banji, I think a trip to the arts and crafts store is in order. I’m going to need more clay!
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There is definitely such a thing as mental health treatment, like your mom is getting only for mental health, that is a step down in intensity from a hospital. It’s called residential treatment. I’ve been to 3 such programs, so if you have any questions about the experience or what to look for or avoid in a place, what sorts of questions to ask when looking at places etc, let me know. Email would be best for that discussion. I unfortunately don’t know of anything off-hand in your state, though I’m sure they exist since they exist everywhere.
I do have to warn though that, although residential is a lot more comfortable and less restrictive than inpatient, there are still restrictions (you wouldn’t be able to keep sharp objects like scissors (though could use them with supervision), or anything containing alcohol (including hair products), they’d be in charge of your schedule, you might not be able to leave the property at all for the first two weeks (or longer), and once you can leave to you’d probably still need to ask permission every time). It can feel patronizing and like you’re being treated like a child. It was worth it for me because I needed the extensive therapy and help with everyday life. I put up with the stuff I didn’t like in exchange for the things I did. But I felt the need to warn you about that in case that would really bother you.
If you want extensive treatment but to continue living at home to avoid such restrictions and be in a familiar place, you could do IOP (intensive outpatient) or partial hospitalization. That would be going to a place every day during the day during the week, then come home at night. Some places have more flexible schedules than others (you might be able to set it up so that you get the # of hours you feel you need, but it doesn’t conflict with your classes). It’s usually mostly groups (there are various groups available and you do the ones that are most appropriate for your needs), though they also will set you up with a case manager and psychiatrist for the duration of the program, who you’ll see one-on-one. The case manager would help you set and reach short- and long-term goals and then help you plan/prepare for discharge when you’re ready (which would include referring you to any outpatient professionals you don’t already have in place and they think you could use). You may also have the opportunity to see other specialists one-on-one as-needed, like an occupational therapist or sleep specialist or addiction specialist or nutritionist etc. (Different programs have different services available, so that would be something to consider in choosing a program; what is most important to you?)
Another option, that I really recommend because it’s intensive and individualized without the restrictions (you live at home), is something called Assertive Community Treatment. This is a treatment approach, not a specific company, so it might exist near you. With this, you’re set up with a team of specialists to work on different things with you, and they meet with each other several times a week to discuss your progress so you don’t have to repeat things with each of them and everyone’s on the same page. The cool thing is they can meet with you anywhere you want, so someone could come help you cook or clean your apartment for instance, or you can have psychiatry in your living room if you’re too depressed or busy or whatever to go to your psychiatrist’s office that day.
Do you have health insurance? If you have health insurance, a lot of programs like this are covered by it. I (well, my parents) only had to pay at all for one of the three programs I did.
Forgot to mention, if this is something you’re seriously considering, I used these websites to find my programs:
http://www.psychologytoday.com (go find a therapist, then find a treatment facility)
Residential: The restrictions you mentioned don’t seem too bad, but I’ll admit I’m not really that crazy about being away from home for an extended period of time. If nothing else, I’d miss my rats, who are an essential part of my treatment team. 🙂
Also, as good as a residential program might be, then I’d have to come home where it’s likely nothing will have changed. I won’t have the support of most of the professionals I’ve come to rely on and developed emotional attachments to. I don’t need that kind of shock to my system.
IOP: My first reaction to the idea of having to go someplace everyday is “Eeek! No! I have enough anxiety about leaving the house without having to do it every day!” Part of me thinks that would be good practice, though; I could really use more structure to my time / a routine (other than “wake up whenever and go online”). Having to go someplace everyday might help me overcome my leaving-the-house anxiety because it’ll become normal again. As long as I could have one day off, when I don’t have to go anywhere, it might be doable. It’s something to consider, at least.
Assertive Community Treatment sounds perfect. I love the idea of having a team who coordinate with each other and can come to me if I’m not able to go to them. The possible help cleaning my apartment is particularly appealing because that’s something I really struggle with. I think Wakana would be willing to work with such a team, as long as they respected her as an equal, someone who can bring a unique and essential perspective to the table (music therapy), and the professional who knows me the best!
I currently have health insurance through my school, but it expires in August. I can’t really justify taking extra electives anymore, nor is that necessarily a good idea because the academic work limits my ability to focus on recovery. The only thing going on in the fall that I need for my program is the thesis seminar; I like the idea of taking it but it’s definitely not something I want to risk skimping on because I’m struggling with depression. Even if I do take it, I won’t have enough credit to qualify for my school’s insurance. There will be several months between the expiration of my current insurance and the option of getting insurance through Obamacare. I might be able to pick up COBRA for the duration. I just hate that it’s so expensive!
I understand your reservations about residential. It’s definitely not for everyone. I had those issues too, especially since I left my state for treatment, but I just felt like I had no other options at the time since I was having trouble leaving the house and I didn’t yet know about Assertive Community Treatment. As far as IOP, while most are every day, some have the option to go only part-time, so that might be something to look into if there isn’t Assertive Community Treatment near you or if you can’t afford it (it’s really expensive without insurance coverage, unfortunately). One of my residential programs was quite flexible in that you could live there (which I did), go every day 9-4, go only in the morning or only in the afternoon, or only do some days (say MWF) depending on your schedule and preferences. Some of the people there, for instance, had part-time jobs, children, school etc and wanted or needed to continue with these things while in the program.
I’m still on my dad’s insurance at 27, which is ordinarily not allowed, but with some insurance companies, you can get an adult child with a disability approved on a family plan past the normal age cutoff of 26 (potentially indefinitely). It’s a pretty long and involved process of applying (you’d need to prove that you have clinical depression that makes you currently unable to work or go to school enough for health insurance), but if your mom has good health insurance, it might be worth it.
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